Association between mucosal surface pattern under near focus technology and infection.

BACKGROUND

Many studies evaluated magnification endoscopy (ME) to correlate changes on the gastric mucosal surface with () infection. However, few studies validated these concepts with high-definition endoscopy without ME.

AIM

To access the association between mucosal surface pattern under near focus technology and infection status in a western population.

METHODS

Cross-sectional study including all patients referred to routine upper endoscopy. Endoscopic exams were performed using standard high definition (S-HD) followed by near focus (NF-HD) examination. Presence of erythema, erosion, atrophy, and nodularity were recorded during S-HD, and surface mucosal pattern was classified using NF-HD in the gastric body. Biopsies were taken for rapid urease test and histology.

RESULTS

One hundred and eighty-seven patients were analyzed from August to November 2019. Of those, 47 (25.1%) were +, and 42 (22.5%) had a previous treatment. In the examination with S-HD, erythema had the best sensitivity for detection (80.9%). Exudate (99.3%), nodularity (97.1%), and atrophy (95.7%) demonstrated better specificity values, but with low sensitivity (6.4%-19.1%). On the other hand, the absence of erythema was strongly associated with - (negative predictive value = 92%). With NF-HD, 56.2% of patients presented type 1 pattern (regular arrangement of collecting venules, RAC), and only 5.7% of RAC+ patients were +. The loss of RAC presented 87.2% sensitivity for detection, 70.7% specificity, 50% positive predictive value, and 94.3% negative predictive value, indicating that loss of RAC was suboptimal to confirm infection, but when RAC was seen, infection was unlikely.

CONCLUSION

The presence of RAC at the NF-HD exam and the absence of erythema at S-HD were highly predictive of negative status. On the other hand, the loss of RAC had a suboptimal correlation with the presence of .